Ebola in Town: Day 7 of 21

The affected West African States won't recover quickly after this epidemic ends, even if that end is currently incalculable. This region will need assistance from the international community more than ever. Liberia's economy is in ruins, the already fragile health system has collapsed, and social networks have been divided by both death and stigma. Ebola has also caused psychological trauma among the living. This will take time - and there will be a lot to do.

The line between genuine fear and real paranoia is so fine that it already threatens to blur. "The aftermath," I was warned, is perhaps even more challenging than the assignment. I can only agree. I have been back for a week in the middle European bubble. I am at day seven of the 21-day incubation period I have to wait through to be sure that I have not been infected with Ebola. A waiting game...

The first seven days were very varied - and the following 14 will probably be even more so. So far, I went through every mood: happiness, to mortal fear. Although I am 99.9 percent sure I am healthy, a minimal doubt remains doubt, at least until day 21.

I can rationalise my mood swings as I repeat over and over again the same themes and stories. Many interested people ask me countless interesting questions. Some of these questions I cannot answer, some I do not want to answer. I can hardly stand hearing the word 'Ebola' anymore.

If you have to perform in the middle of this mad swirl of Ebola, a part of you will become part of it. You repress, you're over busy with so many tasks and you lack the distance to what you experience. Ripped out of this maelstrom, your repressed experiences return suddenly and replace the real danger. Your sense of security turns out to be void; it feels like weightlessness through which a new state appears: paranoia. It takes a while until this sense normalises.

Photo: Martin Zinggl/MSF

An MSF member of staff takes a break at the end of the day

The contrasts between this whole and healthy world and the other catastrophic world seem now much more extreme to me than ever before. I had my first hearty laugh from the chest when I had a table full of different foods before me - food that was not only rice with tomato sauce. My second laugh was when I took a shower and a stream of warm water hailed down on me. The third laugh was when I snuggled into my cosy bed. Well-fed and with a clean body, I still could not sleep. Is this maybe due to the malaria prophylaxis I still have to take? Is it because of what I experienced and have seen? Or is it maybe due to my wretched attempt to make the two realities compatible with each other?

Where have I been? And who was I during this time? I smelled different, I tasted different, I saw and listened different. All my sensations felt different in this somehow unrealistic appearing world called Liberia. My mind, especially, was working differently. For seven days now, I have been thinking of returning to Liberia. Is that a good sign? I don't know. Part of me is probably still in Liberia, at least up until 21 days.

In the last week of my stay, the patient numbers in our centre reduced significantly. Is this an indication that the Ebola epidemic is slowly coming to end? Hardly, it is rather the calm before the next storm. It more likely might mean that the epicentres of the epidemic shift. We increasingly received patients from surrounding provinces in those past days, even from the capital Monrovia. We received people who are so desperate that they take on a day trip to come to Foya, although they can be in in Monrovia within an hour or less.

Photo: Martin Zinggl/MSF

The house of an Ebola patient who unfortunately did not survive

We are currently experiencing an unprecedented scenario in West Africa, and yet we are only seeing the tip of the Ebola iceberg. And I still wonder: is the international community even aware of it? Are we aware that this epidemic won't disappear within a few weeks? Certainly not by itself. And most importantly: what happens next?

The affected West African States won't recover quickly after this epidemic ends, even if that end is currently incalculable. This region will need assistance from the international community more than ever. Liberia's economy is in ruins, the already fragile health system has collapsed, and social networks have been divided by both death and stigma. Ebola has also caused psychological trauma among the living. This will take time - and there will be a lot to do.